학술논문
Ethical issues encountered by French intensive care unit caregivers during the first COVID-19 outbreak.
Document Type
Academic Journal
Author
Therond C; (UMR) Unité mixte de recherche 7268 ADES (Anthropologie bioculturelle, Droit, Ethique et Santé), CNRS (Centre Nationale de Recherche Scientifique), EFS (Etablissement Français du Sang), Aix-Marseille University, Marseille, France. corentintherond@gmail.com.; Saliba-Serre B; (UMR) Unité mixte de recherche 7268 ADES (Anthropologie bioculturelle, Droit, Ethique et Santé), CNRS (Centre Nationale de Recherche Scientifique), EFS (Etablissement Français du Sang), Aix-Marseille University, Marseille, France.; Le Coz P; (UMR) Unité mixte de recherche 7268 ADES (Anthropologie bioculturelle, Droit, Ethique et Santé), CNRS (Centre Nationale de Recherche Scientifique), EFS (Etablissement Français du Sang), Aix-Marseille University, Marseille, France.; Eon B; (UMR) Unité mixte de recherche 7268 ADES (Anthropologie bioculturelle, Droit, Ethique et Santé), CNRS (Centre Nationale de Recherche Scientifique), EFS (Etablissement Français du Sang), Aix-Marseille University, Marseille, France.; Direction Qualité Gestion des Risques/Cellule Qualité gestion des risques, AP-HM Hospital Timone, Marseille, France.; Michel F; (UMR) Unité mixte de recherche 7268 ADES (Anthropologie bioculturelle, Droit, Ethique et Santé), CNRS (Centre Nationale de Recherche Scientifique), EFS (Etablissement Français du Sang), Aix-Marseille University, Marseille, France.; Service d'anesthésie et réanimation pédiatrique, AP-HM Hospital Timone, Marseille, France.; Piriou V; Service d'Anesthésie et de Réanimation, Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon, France.; Research on Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, Lyon, France.; Lamblin A; (UMR) Unité mixte de recherche 7268 ADES (Anthropologie bioculturelle, Droit, Ethique et Santé), CNRS (Centre Nationale de Recherche Scientifique), EFS (Etablissement Français du Sang), Aix-Marseille University, Marseille, France.; Service civilo-militaire d'anesthésie-réanimation, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.; Douplat M; (UMR) Unité mixte de recherche 7268 ADES (Anthropologie bioculturelle, Droit, Ethique et Santé), CNRS (Centre Nationale de Recherche Scientifique), EFS (Etablissement Français du Sang), Aix-Marseille University, Marseille, France.; Research on Healthcare Performance (RESHAPE), Université Claude Bernard Lyon 1, Lyon, France.; Service des Urgences de Lyon Sud, Hôpital Lyon Sud, Hospices Civils de Lyon, Lyon, France.
Source
Publisher: Springer New York Country of Publication: United States NLM ID: 8701709 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1496-8975 (Electronic) Linking ISSN: 0832610X NLM ISO Abbreviation: Can J Anaesth Subsets: MEDLINE
Subject
Language
English
Abstract
Purpose: We aimed to describe the ethical issues encountered by health care workers during the first COVID-19 outbreak in French intensive care units (ICUs), and the factors associated with their emergence.
Methods: This descriptive multicentre survey study was conducted by distributing a questionnaire to 26 French ICUs, from 1 June to 1 October 2020. Physicians, residents, nurses, and orderlies who worked in an ICU during the first COVID-19 outbreak were included. Multiple logistic regression models were performed to identify the factors associated with ethical issues.
Results: Among the 4,670 questionnaires sent out, 1,188 responses were received, giving a participation rate of 25.4%. Overall, 953 participants (80.2%) reported experiencing issue(s) while caring for patients during the first COVID-19 outbreak. The most common issues encountered concerned the restriction of family visits in the ICU (91.7%) and the risk of contamination for health care workers (72.3%). Nurses and orderlies faced this latter issue more than physicians (adjusted odds ratio [ORa ], 2.98; 95% confidence interval [CI], 1.87 to 4.76; P < 0.001 and OR a , 4.35; 95% CI, 2.08 to 9.12; P < 0.001, respectively). They also faced more the issue "act contrary to the patient's advance directives" (OR a , 4.59; 95% CI, 1.74 to 12.08; P < 0.01 and OR a , 10.65; 95% CI, 3.71 to 30.60; P < 0.001, respectively). A total of 1,132 (86.9%) respondents thought that ethics training should be better integrated into the initial training of health care workers.
Conclusion: Eight out of ten responding French ICU health care workers experienced ethical issues during the first COVID-19 outbreak. Identifying these issues is a first step towards anticipating and managing such issues, particularly in the context of potential future health crises.
(© 2023. Canadian Anesthesiologists' Society.)
Methods: This descriptive multicentre survey study was conducted by distributing a questionnaire to 26 French ICUs, from 1 June to 1 October 2020. Physicians, residents, nurses, and orderlies who worked in an ICU during the first COVID-19 outbreak were included. Multiple logistic regression models were performed to identify the factors associated with ethical issues.
Results: Among the 4,670 questionnaires sent out, 1,188 responses were received, giving a participation rate of 25.4%. Overall, 953 participants (80.2%) reported experiencing issue(s) while caring for patients during the first COVID-19 outbreak. The most common issues encountered concerned the restriction of family visits in the ICU (91.7%) and the risk of contamination for health care workers (72.3%). Nurses and orderlies faced this latter issue more than physicians (adjusted odds ratio [OR
Conclusion: Eight out of ten responding French ICU health care workers experienced ethical issues during the first COVID-19 outbreak. Identifying these issues is a first step towards anticipating and managing such issues, particularly in the context of potential future health crises.
(© 2023. Canadian Anesthesiologists' Society.)